Examining the early distribution of the artemisinin-resistant Plasmodium falciparum kelch13 R561H mutation in Rwanda

Rebecca Kirby; David Giesbrecht; Corine Karema; Oliver John Watson; Savannah Nicole Lewis; Tharcisse Munyaneza; Jean De Dieu Butera; Jonathan J. Juliano; Jeffrey A. Bailey; Jean Baptiste Mazarati

doi:10.1101/2022.10.26.513523

GenomicsbioRxivOct 26, 2022

Preprint

Examining the early distribution of the artemisinin-resistant Plasmodium falciparum kelch13 R561H mutation in Rwanda

Rebecca Kirby iD, David Giesbrecht iD, Corine Karema iD, Oliver John Watson iD, Savannah Nicole Lewis iD, Tharcisse Munyaneza, Jean De Dieu Butera, Jonathan J. Juliano iD, Jeffrey A. Bailey iD, Jean Baptiste Mazarati iD

Abstract

Artemisinin resistance mutations in Plasmodium falciparum kelch13 (Pfk13) have begun to emerge in Africa. Pfk13-R561H was the first reported African mutation found in Rwanda in 2014, but limited sampling left questions about its early distribution and origin. We detected 476 parasitemias among 1873 residual blood spots from a 2014-15 Rwanda Demographic Health Survey. We sequenced 351 samples revealing 341/351 were wild type (97.03% weighted) and 4 samples (1.34% weighted) harbored R561H which were significantly spatially clustered. Our study better defines the early distribution of R561H in Rwanda and suggests that the origin may have involved higher-transmission regions.

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